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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||- / 1||- / -|
Administered by: Other Purchased by: ??
Symptoms: Cardiac failure acute, Cardiogenic shock
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021173800
Write-up: Cardiogenic shock; Acute cardiac insufficiency; This is a spontaneous report from a non-contactable physician downloaded from the Agency Regulatory Authority-WEB (Regulatory Authority number DE-PEI-PEI2021002626). A 100 years old female received the first single dose of BNT162B2 (COMIRNATY) on 15Jan2021, for COVID-19 immunization. Medical history and concomitant medications were not reported. On 19Jan2021, four days after vaccination, the patient developed cardiogenic shock and acute cardiac insufficiency, lasting for 5 days. The patient died on an unspecified date in 2021. Cause of death was reported as acute cardiac insufficiency, however both cardiogenic shock and acute cardiac insufficiency were reported with a fatal outcome. Stop date of both events was reported as 23Jan2021 (death date was not clearly specified). It was unknown if an autopsy was done. Relatedness of drug to reaction(s)/event(s) assessed as D. Unclassifiable by Regulatory Authority. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Acute cardiac insufficiency; Cardiogenic shock
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